NRNP 665 Assignment: Patient Education for Children and Adolescents Assignment: Patient Education for Children and Adolescents

NRNP 665 Assignment: Patient Education for Children and Adolescents Assignment: Patient Education for Children and Adolescents

Introduction

Depression is a mental health disorder characterized by sadness, loss of interest in activities, and depressed or irritable mood severe enough to affect an individual’s ability to function effectively significantly. It is a common mental illness that can occur at any age and affects how individuals feel, thinks, and acts. It can result in emotional or physical problems that can interfere with the individual’s ability to function. There are several depressive disorders which include major depressive disorder, persistent depressive disorder (dysthymia), disruptive mood dysregulation disorder, premenstrual dysphoric disorder, substance/medication-induced depressive disorder, and unspecified depressive disorder (American Psychiatric Association, 2013). This paper aims to discuss persistent depressive disorder (dysthymia), its signs and symptoms, pharmacological and nonpharmacological interventions, and possible community referrals.

Persistent Depressive Disorder (Dysthymia)

Persistent depressive disorder, also called dysthymia, is a combination of chronic major depressive disorder and dysthymic disorder characterized by low mood for most of the day, occurring for at least two years for adults. It can be diagnosed in pediatric patients, either children or adolescents when the depressed or irritable mood is present for at least one year (American Psychiatric Association, 2013). During the 2 or 1 year period of the illness, two or more of the following symptoms such as poor appetite or overeating, insomnia or hypersomnia, low energy, fatigue, low self-esteem, poor concentration, and feelings of hopelessness, must also be present (American Psychiatric Association, 2013). Many factors can trigger the risk of persistent depressive disorder in children or adolescents, such as increased stress, physical or emotional trauma, abuse, neglect, loss of a parent, caregiver, or relationship, health-related problems, developmental or learning disabilities, and substance use.

Signs and Symptoms of Persistent Depressive Disorder

Depression can cause lower quality of life, higher risk of suicide, disability,  and loss of productivity. Unfortunately, depression is often undiagnosed because of failure to recognize the symptoms and seek mental health care (Farid et al., 2020). Individuals with persistent depressive disorder have different symptoms, and they include sadness, low self-esteem, feelings of despair, helplessness or guilt, suicidal thoughts and attempts, sleep problems, problems with appetite, low energy, problems with focus and concentration, irritability, aggression, fatigue, loss of interest in usual activities, running away from home, and feelings of rejection. If your child experiences two of these symptoms, please notify the child’s health care provider, and provide details of the child’s clinical presentation. This disorder can be treated with medications and psychotherapy.

Pharmacological Treatment of Persistent Depressive Disorder (Dysthymia)

There are FDA-approved medications that can be used to treat depression in pediatric patients. They include Escitalopram (Lexapro) for individuals between 12 and 17 years and Fluoxetine (Prozac) for ages between 8 and 17 years.

Escitalopram (Lexapro) and Fluoxetine (Prozac) are antidepressants that belong to the class of medications called the Selective serotonin reuptake inhibitor (SSRIs), used primarily for the treatment of depression and anxiety. These medications work by increasing the chemical serotonin in the brain. Studies have shown that adolescents with persistent depressive disorder treated with these antidepressants showed significant improvement in symptoms, better response, and remission rates. They are generally well-tolerated, and few individuals experience adverse reactions, usually occurring within the first eight weeks (Findling et al., 2013).

Nonpharmacological Treatment of Persistent Depressive Disorder

Persistent depressive disorder can also be treated without the use of medications or by combining medications with therapies. Psychotherapies have been studied and proven to be effective in significantly reducing depressive symptoms and helping patients to develop coping skills to manage these symptoms effectively. The psychotherapies include Cognitive behavioral therapy (CBT), Interpersonal psychotherapy, and the cognitive-behavioral analysis system of psychotherapy.

• Cognitive Behavioral Therapy (CBT): Individuals suffering from depression are taught cognitive and behavioral skills to help them develop more positive beliefs about themselves, others, and the world. It helps them to learn to value their own feelings, replace behaviors that generate negative feelings with more appropriate behaviors
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